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ARCHIVED REPORTS XR0000658
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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CAPITOL
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6421
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2900 - Site Mitigation Program
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PR0522496
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ARCHIVED REPORTS XR0000658
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Entry Properties
Last modified
2/15/2019 8:06:41 PM
Creation date
2/15/2019 3:10:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000658
RECORD_ID
PR0522496
PE
2957
FACILITY_ID
FA0015317
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95245
APN
05532024
CURRENT_STATUS
02
SITE_LOCATION
6421 CAPITOL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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i <br /> 0 SENDER: i also wish to receive the <br /> •Complete Items 1 and/or 2 for additlonal services <br /> aComplete Items 3, 4a, and 4b following services (for an <br /> ■Print your name and address on the reverse of this form so that we can return this extra fee). <br /> card to you <br /> •Attach this form to the trflnt of the maiipiece, or on the back If space does not t ❑ Addressee's Address <br /> permit <br /> ■Wnte'Retum Receipt Requested'on the mailpiece below the article number 2, ❑ Restricted Dellvery 6 <br /> ■The Return Receipt will show to whom the article was delivered and the date 4 <br /> C delivered Consult postmaster for fee <br /> o i <br /> 0 3. Arb le Address to: 4a Article NumberCL j <br /> , <br /> E ) „ j "` �• �( � rel f )`. � ��I � S �`���s�� Qb Service Type ,r <br /> ❑ Registered Certified i <br /> f�c If �''f / �� f� p Express Mall ❑ Insured <br /> �� ) etum Receipt for Merchandise [I COD <br /> O - { r`, 7 Date of Delivery <br /> zZO <br /> lZ <br /> 5. Received By (Print Name) 8 Addressee's Address (Duly If requested <br /> W and fee is pald) <br /> 6 Signature- (Addressee orA ent) <br /> o X ' <br /> �+ <br /> PS Form 3811, December 1994 Domestic Return Receipt <br />
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